How to control anxiety and stress, the best tricks

Don't let anxiety and stress get to you, here we tell you the best tricks to overcome it successfully.

It has become so popular that anxiety or stress is spoken of as if it were the flu. The consequence is a boom in the consumption of anxiolytics that, at the first opportunity, your office colleague offers you as if he were inviting you to chewing gum. But is medication a solution?

Alberto Durán had always considered himself capable of handling day-to-day conflicts. Not even the teenage son broke his emotional strength. He had gone through several bad patches in his life: two marital crises, two layoffs, a job challenge that he managed to overcome... However, in 2017, when he was 45, while completing a routine at the gym, he began to feel palpitations that he could not explain. “It was not a tachycardia, it was a strange sensation.

As if my heart was wearing out,” he explains. At that time, she asked a colleague to take her to the emergency room at a Madrid hospital. “As soon as I entered they did an electrocardiogram. And everything was fine." Once it was ruled out that this was a cardiac arrest, the wait in the emergency room lasted several hours. But Alberto was still alarmed. "I noticed that something was happening to me, something that compromised my life." After seeing the results of an analysis, the internist who treated him asked him this question: "Who are you fighting with?" At first, Alberto did not quite understand what he meant. “What is your conflict?” repeated the doctor. "Your partner? The job? The neighbor?". For a couple of months, Alberto hadn't slept well, he woke up at dawn and couldn't sleep again.

Despite his insistence that something was wrong with his heart, he left the ER with a prescription to buy one of the most prescribed anti-anxiety treatments, whose active ingredient is alprazolam. It was difficult for him to accept that what was happening to him was an anxiety crisis, but he decided to try alprazolam, half a milligram twice a day, and it was not long before he noticed that due to the effects of the medication, his mood was close to being euphoric. . "It looks like a pill dropped from the sky," he says.

As happened to him and, according to the WHO, up to 29% of people will suffer from an anxiety disorder at least once during their life. Even so, that does not have to mean anything bad in principle. “Anxiety is a natural and innate emotion like any other. In itself, it is not negative. It's like fear, it helps you be alert to conflicts”, says Juan José Miguel Tobal, Professor of Psychology at the UCM. But that natural emotion can overflow. "When the frequency, intensity, or duration of symptoms interfere with day-to-day life, it can become pathological anxiety," he adds. And, if it persists, it turns into a nightmare.

Mental health specialists recognize anxiety (a term that encompasses social anxiety and post-traumatic stress disorder, or PTSD) as a real mental disorder and identify some key features that it shares with depression. Dr. Tobal recounts an example as a trigger for a crisis: “Any day in the morning, at a rush hour on the subway, there is a power cut and you get stuck between two stations. You begin to notice that you are uncomfortable in the dark, the emergency light bothers you. You notice the expressions of other people who feel the same: tremors, tachycardia, rapid breathing, muscular tension and maybe a traveler loses control and falls to the ground like a lead.

Everything is solved in a few hours but, from that day on, you go to work by bus”. The most normal thing before a panic attack is that it is easy for one to become sensitized and have a greater propensity for it to happen again. “When we avoid increasingly important things, we can fall into anxiety with agoraphobia. I have had patients who have been confined to their homes for years, so that nothing happens to them. They get locked up, and a depression begins.

This is not the most frequent, but they are the most extreme cases. It affects 3% of the population. Before reaching that abyss, action must be taken. In Spain we are in low figures compared to other areas regarding generalized anxiety. “Mediterranean countries such as Spain or Italy are at a medium-low level of affected. The yearly prevalence (percentage of people per year who will suffer from the disease) in Spain is 5.9%. In the US it exceeds 18%. France surprises, because its figures shoot up to 13% despite being a Mediterranean country. In Asian countries, however, they have the lowest figures: 2.5%”.

In our country we live a paranormal phenomenon. We have low disease figures; however, we rank second in the world in the consumption of drugs to treat it. Only Portugal surpasses us (without explaining very well why). The use of bezodiazepines or other anxiety blockers is in the top ten in our country. Often because they are consumed without a prescription. Has a colleague passed you a pill at a bad time?

You may be faced with something new, public speaking or a job interview, and the situation overwhelms you. You may have sweating, trembling hands, fear of blanking out... and that is the moment when your partner or an office colleague offers you to take a propranolol or any other anxiety blocker. Even if you are one of those who look closely at the ingredients even of the tomato sauce before adding it to the pasta, however, you take the pill without further ado.

Before you do, you may recall Jennifer Lawrence's confession after she walked onto the stage at the Golden Globes in a state very similar to drunkenness. Watch the video several times before you take the pill, because it is very likely that the abuse of medications during your talk will play you. Lawrence confessed that her pills had gotten out of hand.

After that critical episode in the gym, Alberto Durán went to his GP. This time he left the consultation with two types of drugs. On the one hand bezodiazepines, and an antidepressant. And you go home. “The Spanish health system does not offer a consultation with a psychologist as a first step in dealing with anxiety problems , which is what should happen. So the GP himself prescribes benzodiazepines and antidepressants”, explains Miguel Tobal.

Benzodiazepines or benzos have been in common use since the 1960s. They are in the formula of the most prescribed medications. In the short term, the anxiety-reducing effect is unquestionable. The problem is that when patients seek pharmacological remedies, doctors prescribe benzodiazepines in more than a quarter of consultations (27 out of 100), a figure that triples the number of benzos prescribed in the mid-1990s.

“The benzodiazepines are not a panacea”, warns the expert. These are highly addictive medications and carry a high risk of overdose, especially when combined with opioids or alcohol or in patients suffering from respiratory problems or sleep apnea. Several studies show that long-term use of benzos and high doses can accelerate the onset of dementia. The simple fact of trying them to relieve anxiety can lead some patients to fall into a vicious cycle from which it is very difficult to escape due to the difficulty involved in disengaging.

“I have had patients whom I have helped to gradually reduce the medication, something agreed between the psychologist and the psychiatrist. But addiction to psychoactive drugs is not currently one of the major problems in Spain. Although I am not sure that it is not hidden”, explains Miguel Tobal. In the US, however, that alarm has already been raised. Anna Lembke, Ph.D., runs a major toxics weaning program at a clinic in Standford, California. Half of her patients are in a deprescription process, that is, trying to abandon the medication that was prescribed for anxiety or depression problems.

"We managed to get most of them, especially those who used small doses of benzodiazepines for decades, to recover a life without drugs," he says, "but it is really difficult to stop." The psychiatrist assures that some people take between 18 and 24 months to completely abandon treatment, "and that with great psychological support."

Science supports the use of benzodiazepines and antidepressants, but for less than two weeks. Before reaching them, even during treatment, there are other activities, these ones that are harmless, that help curb anxiety, are cheap (even free) and are in your hands. "Yoga, meditation and physical exercise have been shown to help combat anxiety," says Dr. Tobal. To start, add this workout to your day to day: the 4-7-8 breathing method (inhale in four sections, hold the breath for a count of seven and exhale in eight sections). And don't worry if it makes you addicted.

anxiety treatment

“Therapy always comes in handy: drugs are sometimes essential to unblock a crisis situation. But the ultimate goal is for the person to be able to live well without the need for drugs”, explains Juan José Miguel Tobal.

situational

Symptoms: For example, you are going to speak in public and notice palpitations and sweating. Your body trembles and you won't be able to.

What to do: Propranolol was popularized against stage fright. But using a drug is like using a wine. It can play tricks on you.

Mild

Symptoms: You begin to have racing thoughts, palpitations, excessive worry, body tension...

What to do: First you have to rule out hyperthyroidism. Meanwhile, do yoga, exercise and see if there is more tension in your day to day.

moderate

Symptoms: The discomfort has already prevented you from going to work, you have a hard time completing routine tasks, and you argue all the time.

What to do: It is time to seek psychological and psychiatric therapy, for experts to evaluate the pros and cons of using drugs in your case.

Severe

Symptoms: The abyss. You don't even want to leave home, you have destructive thoughts, you fell into depression.

What to do: The treatment recommended by your doctors will be benzodiazepines in combination with antidepressants and cognitive behavioral therapy.